Dr. R. Zatzman

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from her insurer.

The insurer terminated her income replacement benefits and denied medical and rehabilitation benefits, maintaining for nearly three years that her injuries fell within the Minor Injury Guideline (MIG).

The arbitrator found that the applicant suffered a substantial inability to perform her pre-accident employment and, post-104 weeks, a complete inability to engage in suitable employment due to chronic pain.

The arbitrator granted the claimed income replacement benefits, medical benefits, and costs of examinations.

Furthermore, the arbitrator awarded a $25,000 Special Award against the insurer, finding that it had unreasonably delayed and denied benefits by relying on patently flawed medical reports and ignoring credible evidence of the applicant's chronic pain.

The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits, a chronic pain program, a chronic pain assessment, and psychological counselling.

The adjudicator dismissed the claim for non-earner benefits, finding that the applicant failed to prove a complete inability to carry on a normal life, as his post-accident limitations were largely similar to his pre-accident condition.

The claims for the chronic pain program and assessment were also dismissed because the applicant had a pre-existing diagnosis of chronic pain syndrome, and the medical evidence failed to establish that the accident materially contributed to it.

However, the adjudicator granted the claim for psychological counselling, finding that the accident materially contributed to an exacerbation of the applicant's pre-existing mental health symptoms, as supported by the respondent's own psychological expert.